Nursing Care Plan

Assessment
SUBJECTIVE: Noong nag bubuntis pa ako ay may mga oras na nag didilim ang aking patingin, nag boblockout ako at parang nahihimatay. Nahihirapan din ako huminga kapag akoy napapagod o kaya naman ay napuyat ako.

Diagnosis
Decreased cardiac output related to altered myocardial contractility /inotropic changes.

Inference
An atrial septal defect (ASD) is a hole in the part of the septum that separates the atria (upper chambers of the heart). This heart defect allows oxygen-rich blood from the left atrium to flow across the atrial septum into the right atrium instead of flowing down to the left ventricle as it should. This is inefficient because oxygenrich blood gets pumped back to the lungs, where it has just been, instead of going to the body. An ASD can be small or large. Small ASDs allow

Planning
After 8 hours of nursing intervention the patient will display vital signs within acceptable limits, dysrhythmias controlled and no symptoms of failure.

Intervention
INDEPENDENT: Auscultate apical pulse; assess heart rate, and rhythm.

Rationale
Tachycardia is usually present even at rest to compensate for decreased ventricular contractility. Pallor is an indicative of diminished peripheral perfusion secondary to inadequate cardiac output, vasoconstriction, and anemia. Cyanosis may develop in refractory heart failure. Dependent areas are often blue or mottled as venous congestion increases. Urine output is usually decreased during the day because of fluid shifts into tissues but may be

Evaluation After 8 hours of nursing intervention the patient was able to display vital signs within acceptable limits, dysrhythmias controlled and no symptoms of failure.

Inspect skin for pallor, cyanosis.

OBJECTIVE: Olive Skin Heart Murmur Orthopnea V/S taken as follows T: 36.2 C P: 130 R: 45

Monitor urine output, noting decreasing output and dark or concentrated urine.

only a little blood to flow from one atrium to the other. Small ASDs don't affect the way the heart works and therefore don't need any special treatment. Many small ASDs close on their own as the heart grows during childhood. Medium to large ASDs allow more blood to leak from one atrium to the other, and they are less likely to close on their own. Most children with ASDs have no symptoms, even if they have large ASDs.

Note changes in sensorium.

Provide quiet environment.

increased at night because fluid returns to circulation when patient is recumbent. May indicate inadequate cerebral perfusion secondary to decreased cardiac output. Psychological rest help reduce emotional stress, which can produce vasoconstriction, elevating BP and increasing heart rate or work. Increases available oxygen for myocardial uptake to combat effects of hypoxia or ischemia. Diuretics, in conjunction with restriction of dietary sodium and fluids, often lead to clinical improvement in patients with heart failure.

DEPENDENT: Administer supplemental oxygen as indicated.

Administer diuretics as prescribed.